Introduction
Over the past three decades, clinical practice guidelines (CPGs) have
increasingly played instrumental roles in standardizing the diagnostic
and treatment processes based on the best available evidence. CPGs are
now essential tools for endorsing evidence-based medicine in clinical
practice.1,2 However, the trustworthiness of CPGs
could be compromised by conflicts of interest (COIs) between CPG authors
and the pharmaceutical industry. Over the past decade, accumulating
evidence has shown prevalent financial relationships between CPG authors
and the healthcare industry.3-9 While not all
financial interactions necessarily lead to problematic relationships or
harmful influences on patients and physicians’ clinical practice, some
can introduce bias into CPG recommendations, potentially compromising
patient-centered care.2,10,11 A recent systematic
review indicated that CPGs and advisory committee reports with COIs were
more likely to make favorable recommendations for pharmaceutical
companies.12
To mitigate concerns about the undue influence of the healthcare
industry on CPG recommendations, many national and international
professional organizations have implemented strict COI management
policies for trustworthy CPG
development.1,2,5,11,13-15 Given the significant
impact of CPGs on patients, clinicians, and other stakeholders,
stringent COI management—including full disclosure, minimization of
COIs among authors and organizations, and the appointment of COI-free
chairpersons for CPGs—is essential. This approach could foster
reliable CPGs and advances patient-centered care in the field of
neurology and beyond.2,3,5,11,16-18 Nevertheless, the
extent of financial COIs among neurology CPG authors has not been
thoroughly investigated to date. Utilizing a publicly accessible
database containing payments to physicians from pharmaceutical
companies, this study aims to evaluate the potential financial COIs
among neurology CPG authors in Japan.